Electronic Medical Records: Going from a Model T to a Lexus – by KSB Hospital Chief Medical Officer Tim Appenheimer, M.D.


My first practice as a fledgling physician in 1981 was in Oregon, Illinois. As I was moving into my new office, the elderly physician whose practice I was inheriting asked if I would like to have the records of his patients for the previous 40 years. Of course, I said.  Within 10 minutes, he reappeared at my office door with a large recipe box full of 3 x 5 notecards. “Here you go,” he said. And that was it! His practice records for 40 years, kept in a recipe box.

Most physicians today dream of returning to that level of simplicity. But, in the “old days”, life was usually shorter, and the path toward death was most often steep and brief. Now, many patients are living decades longer with more chronic conditions, more providers and consultants, more medications, more procedures, and more medical episodes. This generates a massive amount of information that must be collected, organized, processed, and made accessible to all caregivers.

Of the total work that goes on during an office visit today, actual medical thinking is only one tiny part of it. Throughout the U.S., physicians are spending much of their clinical time entering medical information into the record. The electronic medical record (EMR) holds the promise of making previously generated information much more accessible and useful. But recording this information is still a very clunky process.

At KSB Hospital, we want to free our physicians to do what they do best. We are experimenting with voice-recognition technology to allow providers to dictate directly into the record. This can be helpful but has real limitations. In some other busy clinical venues, we are using scribes, persons whose sole function is to record medical information in a usable form, while accompanying the provider during the patient visit.

Think of it this way:  today’s electronic medical record is a Ford Model T. It is not yet easy to operate or maintain, but it can often get you where you need to go in a much more convenient, efficient way. Someday the EMR will be a Lexus. At KSB, we are working every day to make this a smoother ride for our clinicians and patients.

1 Comment
  • Jason Brusky
    Posted at 10:13h, 27 August Reply

    Interesting anology. Back when the Model T was out, a horse was easier to use and was often a quicker means of transportation. Providers insist the old paper system was easier to use and ofter quicker. The modern car (Lexus) is definitely easier to use (I would not trust myself to saddle a horse or even put in a bit.) and quicker than a horse. I truly hope (and believe it will) live up to the automobile anology you used.

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